The Trump administration has given states three more years to meet federal standards aimed at helping elderly and disabled Medicaid enrollees receive services without being forced to go into nursing homes.

Centers for Medicare & Medicaid Services Administrator Seema Verma will recuse herself from the agency’s decision-making on whether to approve Kentucky’s Medicaid waiver because she helped develop the proposal in her former job as a health policy consultant.

The woman set to run the federal Centers for Medicare & Medicaid Services told senators last week that maternity coverage should be optional in individual and small group plans. But other services could also be left on the cutting room floor.

After a tough fight by Democrats, Senate Republicans confirmed Rep. Tom Price’s nomination to head the Department of Health and Human Services. He will have the authority to upend some current practices.

According to a settlement four years ago, Medicare was supposed to make clear to therapists that their services are covered even if beneficiaries are not improving. But that is not yet widely accepted.